FEASIBILITY STUDY OF RESPIRATORY QUESTIONNAIRE AND PEAK FLOW RECORDINGS IN AUTOBODY SHOP WORKERS EXPOSED TO ISOCYANATE-CONTAINING SPRAY PAINT - OBSERVATIONS AND LIMITATIONS

Diisocyanates, highly reactive monomers which cross-link polyurethane, are the most widely recognized causes of occupational asthma. Many ex posed workers are end-users, including autobody spray painters who for m a large population at risk. Neither the factors which determine inci dence rate nor strategies for control have been adequately studied in this setting. We have conducted a cross-sectional survey of 23 (about one in five) autobody shops in the New Haven area to determine the fea sibility of clinical epidemiological studies in this population. Among 102 workers, there was a high rate of airway symptoms consistent with occupational asthma (19.6%). Symptoms were most prevalent among those with the greatest opportunity for exposure (dedicated spray painters) and least among office workers; part-time painters had intermediate r ates. Atopy was not associated with risk while smoking seemed to corre late with symptoms. Regular use of air-supplied respirators appeared t o be associated with lower risk among workers who painted part- or ful l-time. We were unable to validate the questionnaire responses with pe ak expiratory flow record data attempted on a 1/3 sample of the worker s. Despite intensive training and effort, subject compliance was limit ed. Among those who provided adequate data (24 of 38), only two demons trated unequivocal evidence of labile airways; two others demonstrated lesser changes consistent with an occupational effect on flow rates. There was no clear association between these findings and either quest ionnaire responses or exposure classification. Overall, the survey sug gests that there is a high prevalence of airway symptoms among workers in autobody shops, at least in part due to work-related asthma. Howev er, there is need for both methodological and substantive research in this setting to document rates of occupational asthma and to develop a scientific basis for its effective control.